Mumbai: June is Men's Mental Health Awareness Month, 30 days dedicated to raising awareness about the unique mental health challenges men face and encouraging them to seek help. One of the topics that especially needs urgent attention and open conversations because the social stigmas surrounding it are manifold, is the issue of erectile dysfunction.

Erectile Dysfunction: Taboos and Health Issues:

Erectile dysfunction is a condition that affects millions of men globally, yet it remains a subject shrouded in silence and discomfort, says Muskan Marwah, Psychologist, Mpower Aditya Birla Education Trust. “Although it is a common medical issue, men hesitate to talk about it due to feelings of shame and cultural taboos. This reluctance can prevent them from seeking proper care, leading to worsening health and emotional challenges. It is important to address these barriers, raise awareness, and foster open conversations about erectile dysfunction,” Marwah said.

Understanding the Social Stigma:

Marwah said that in many societies, a man’s sexual ability is closely linked to his sense of masculinity and self-esteem. “It is because of these deeply ingrained beliefs that men experiencing erectile dysfunction often feel ashamed or vulnerable. Acknowledging the problem may seem like admitting defeat, which discourages many from discussing their condition with loved ones or healthcare professionals,” she said.

In more traditional cultures, sexual health is still a taboo topic, sometimes even within clinical environments, the psychologist opined. “This silence creates isolation, making it difficult for men to access the support and treatment they need. Consequently, some may try unproven remedies or harmful self-treatments, which can worsen their situation,” she added.

Medical Factors Behind Erectile Dysfunction:

Erectile dysfunction is often a symptom rather than a standalone problem, Marwah said. “It frequently points to underlying health conditions, particularly those that affect blood circulation. Diseases such as hypertension, diabetes, high cholesterol, and heart problems can damage the blood vessels and nerves essential for an erection. Lifestyle habits also play a crucial role. Smoking, obesity, physical inactivity, and excessive alcohol consumption increase the risk. Certain medications and hormonal imbalances can contribute as well. Mental health issues, including stress, anxiety, depression, and relationship difficulties, often intensify or trigger erectile dysfunction. Since physical and psychological factors commonly overlap, accurate diagnosis and comprehensive treatment are necessary,” the psychologist noted.

Can It Be Treated? Just like diabetes, high blood pressure, or hormonal imbalances may need, ED can be managed effectively. In some cases, medications, and counseling, might suffice while in others, surgery might be the answer, said Dr Samrat Shah, Internal Medicine Expert, Apollo Spectra Pune. “What is of utmost importance is that, one consults an expert at the earliest,” Dr Shah said. 

The Emotional Toll:

Marwah said that beyond the physical impact, erectile dysfunction can deeply affect a man’s mental health. “Feelings of frustration, embarrassment, and lowered confidence are common, influencing day-to-day life and professional performance. In intimate relationships, the condition can lead to misunderstandings, emotional distance, and hurt feelings. Partners may mistakenly assume the problem is due to a lack of attraction, rather than a medical issue,” she added.

Thane-based psychiatrist and sexologist, Dr Sailesh Umate, shed a few unknown facts about erectile dysfunction. He said that almost 25 per cent of patients suffering from ED have performance anxiety issues. “Depression is 3x times higher in such cases,” he added.

He stated a few factors that are responsible for such heightened levels of anxiety and depression:

  1. The constant pressure to either perform or please their partner leads to overthinking and negativity
  2. Fear of failure.
  3. Reduced self-esteem.
  4. Performance anxiety arises from body image issues, penis size virility issues and relationship issues
  5. Speaking on the long-term impacts of such conditions, Pune-based psychologist and psychotherapist, Dr Shruti Khare, said that over time, these interconnected factors may lead to a vicious cycle of shame, embarrassment, and emotional withdrawal, profoundly affecting an individual's overall mental well-being. “The guilt stems from feelings of inadequacy, shame about masculinity/ expectations, and self-blame for disappointing their partner. This triggers performance anxiety, where fear of failure actually worsens the condition. It's a tough cycle TBH... the more they worry or feel guilty, the harder it gets, and that just fuels more anxiety,” she added.

Myths regarding Erectile Dysfunction (ED):

ED is often misunderstood, leading to myths that can delay timely help. Dr Sanman Gowda, Senior Consultant and HOD, Department of Urology, KMC Hospital Mangalore, and Dr Dr Samrat Shah, Internal Medicine Expert, Apollo Spectra Pune help us debunk some common misconceptions with facts.

  • ED is permanent: In more than 90 per cent of cases, ED is not permanent. It can be temporary and linked to factors such as stress, lifestyle habits, underlying medical issues, or medications. With proper treatment or lifestyle changes, most men recover normal function.
  • One should be able to get an erection at will: While theoretically possible, it’s not that simple. Erection is a complex hormonal and vascular process. Conditions like stress, underlying health problems, alcohol or nicotine use, social circumstances, lack of cooperation from a partner, or medications can interfere. A healthy young man with no stress or medications may get an erection at will, but this isn’t the standard for everyone.
  • Is erectile dysfunction a psychological issue? Psychological causes like anxiety, performance pressure, or depression can also play a major role, especially in younger individuals. Mental health is a vital piece of the puzzle.
  • Low testosterone causes ED: It is one of the causes of ED, but not the only one. Hormonal imbalance may reduce libido and affect erections, but vascular and neurological health matter equally. Remember, ED is linked to blood flow issues, nerve problems, and stress.
  • Drugs and alcohol trigger ED? Yes, they disrupt blood flow, nerve function, and hormonal balance, which can lead to or worsen ED over time. Over time, these substances lower libido and hormone levels, resulting in poor performance.
  • Caffeine intake causes ED: Excessive caffeine consumption or added sugar in caffeinated drinks might lead to erectile dysfunction. While moderate intake is generally safe, high doses can increase anxiety, disturb sleep, and raise blood pressure—all of which can affect sexual performance. 

“ED is common and often temporary. Understanding its multifactorial nature—physical, psychological, and lifestyle-related—can help men take the right steps toward recovery. Myths only delay care; knowledge leads to solutions,” Dr Gowda added.